昆明地区高危HPV病毒载量与宫颈病变和宫颈癌相关性

The correlation of high risk HPV viral load and cervical lesions and cervical cancer in Kunming area

目的了解昆明地区高危人乳头瘤病毒(human papilloma virus,HPV)载量与宫颈病变和宫颈癌相关性。方法选取昆明地区妇女两万余例,用杂交捕获Ⅱ(second-generation Hybrid Capture,HC-II)方法检测高危型HPV-DNA,选取3608例进行阴道镜下多点活组织检查送病理检查,宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)患者以宫颈锥切术后病理检查结果为准,宫颈癌患者以术后病理检查为准,分析HPV病毒载量与宫颈病变级别的相关性。结果宫颈炎2420例(67.07%),CINⅠ448例(12.42%)、CINⅡ376例(10.42%)、CINⅢ280例(7.76%)、宫颈癌84例(2.33%)。经秩和检验,5组间的HPV病毒载量比较,差异有统计学意义(H=185.597,P<0.05);CINⅠ与宫颈炎、宫颈癌和CINⅡ的病毒载量比较,差异均无统计学意义(P>0.05);余下各组两两比较差异有统计学意义(P<0.05)。年龄和HPV病毒载量均是宫颈病变和宫颈癌的危险因素。CINⅡ以上病变随着病毒载量的升高,阳性率逐渐增高。而宫颈癌主要集中在中度级别病毒载量之间发病。结论不同宫颈病变级别间HPV病毒载量有差别,HPV病毒载量可作为诊断CINⅡ以上病变的指标。

Objective To understand the correlation of highrisk human papilloma virus （HPV） viral load and cervical lesions and cervical cancer in Kunming area. Methods High - risk types of HPV - DNA of twenty thousand eases in Kunming area were detected by second - generation Hybrid Capture （ HC - YI）. About 3 608 cases were made by the multiple colposcopy and the biopsy. The correlation of HPV viral load and cervical lesions and cervical cancer were analyzed by the data from cervical conization pathologic examination results of the patients with cervical intraepithelial neoplasia （CIN） and the patho - examination results of patients with cervical cancer.Results There were 2 420 cases with cervicitis （67. 07% ） ,448 cases with CIN I （ 12.42% ） ,376 cases with CIN ]] （10. 42% ）,280 cases with CIN III （7. 76% ）,84 cases with cervical cancer （2. 33% ）. Through the rank sum test, the HPV viral load was significant difference （H = 185. 597,P 〈 0. 05 ） among five groups. While the HPV viral load was no significant difference （ P 〉 0.05 ） between the group of CIN I and the group of cervicitis or between the group of cervical cancer and the group of CIN Ⅱ. Significant statistics difference was found in multiple comparison （ P 〈 0.05 ）. The age and HPV viral load volume were risk factors for cervical lesions and cervical cancer. More positive rate gradually increased with the viral load increasing in more severe lesions of CINⅡ. Cervical cancer was mainly concentrated in the moderate level of viral load. Conclusion The different cervical lesion level was different in HPV viral load and HPV viral load can be used as indicators of diagnosis of CIN II above lesions.